SB139 - Delaware's Fertility Care & preservation Law

SB139 - Frequently Asked Questions

When DID SB139 Go Into Effect?

SB139 went into effect on June 30, 2018 after Governor Carney signed the bill into law. It will apply when the employer’s insurance company has their first annual enrollment after this date. Please note most companies’ annual enrollment takes effect in January of each year. Please contact your HR Department to determine when your annual enrollment date.

WHY ARE SELF-INSURED COMPANIES NOT AFFECTED BY THE BILL?

Federal law states that NO company or organization that self-insures is required to adopt any state insurance mandate.

Why are Delaware State Employees Excluded From This bill?

The State of Delaware self-insures and coverage under the state employee plan is only subject to federal statutes and regulations. This is true for all companies or organizations that self-insure. Senator Townsend and Representative Longhurst have already taken action with the State Employee Benefits Commission (SEBC). SEBC decides whether to adopt insurance laws, like SB139 for state employees. Please come back as updates will be posted.

MY COMPANY IS BASED IN ANOTHER STATE BUT I WORK IN A DELAWARE OFFICE. WOULD THAT MEAN THAT PEOPLE LIKE ME WHOSE JOBS ARE BASED OUT OF STATE, BUT LIVE IN DELAWARE BE EXCLUDED?

It’s best you contact your company’s HR department to determine if your coverage would adhere to Delaware insurance laws. Unfortunately, employer-sponsored insurance is generally based on where the employer resides, but depending on the size of the company, it’s possible that your insurance could be Delaware-based.

DOES SB139 COVER DONOR EGGS, DONOR SPERM, AND /OR DONOR EMBRYOS?

The legislation covers only the treatment associated with the use of donor embryos, eggs and sperm, such as intrauterine insemination, assisted hatching of embryos, cryopreservation and thawing of embryos, eggs and sperm, embryo biopsy, fresh and frozen embryo transfers, intra-cytoplasmic sperm injection, medications, storage of embryos, eggs and sperm. It does not cover the actual cost associated with acquiring donor embryos, eggs and sperm. You would be responsible for this cost out of pocket.

Can this insurance be purchased in the marketplace?

All individual health insurance plans sold on the Affordable Care Act (ACA) Delaware Health Insurance Marketplace will include fertility care and preservation coverage defined by SB 139. Open enrollment begins November 1, 2018 and ends December 15, 2018, with coverage beginning January 1, 2019. Learn more here: www.Choosehealthde.com. You will be able to preview health insurance plan options and prices shortly before the November 1, 2018 enrollment starts at: www.healthcare.gov.

QUESTION 1

Does my employer have 50 or more eligible employees?

No – you are not subject to the mandate. Your questions stop here.

Yes– proceed to question #2.

QUESTION 2

Is your health insurance plan self-funded?

Yes – your company’s health insurance policy is NOT subject to the mandate. This is per federal law. Your questions stop here.

No – proceed to question #3

Some examples of companies who are self-funded are State of Delaware, City of Wilmington, New Castle County and CCHS.

QUESTION 3

When is my annual enrollment?

It is important to know this because the mandate will go into effect on applicable plans at the next annual enrollment following June 30, 2018.

QUESTION 4

Is my company based in Delaware?

If the answer is no, you will need to specifically ask if they will be adopting the mandate in Delaware. Unfortunately, employer-sponsored insurance is generally based on where the employer resides, however, it is possible that your insurance could be Delaware-based.

Stay Up-To-Date With The Latest Buzz

Sign up for our online newsletter for updates and news about our services, research study opportunities, upcoming events, and more.